Chondrosarcoma

A chondrosarcoma is a type of rare bone cancer that typically develops in cartilage — the connective tissue that protects your joints and bones. Healthcare providers may call this condition a sarcoma. Chondrosarcomas are very rare, affecting 1 in 200,000 people in the U.S.

This cancer can appear anywhere you have cartilage, but it usually forms in your:

• Arms and shoulder blades
• Breastbone
• Legs
• Pelvis
• Ribs

They may also develop in benign bone tumors that become cancerous.

Types

There are different types of chondrosarcomas:

• Conventional: This type accounts for more than 85% of all chondrosarcomas. It develops in your thigh bone, upper arm bone or pelvis. It grows slowly and is less likely to spread than other types.
• Dedifferentiated: These fast-growing tumors usually develop in your upper arm bone, thigh bone or pelvis. Some cells start out as typical chondrosarcomas. Then, parts of the tumor change into cells like those of a high-grade sarcoma. High-grade sarcomas tend to grow and spread fast.
• Clear cell: Clear cell chondrosarcomas are typically found near a joint in your arm or leg. They tend to grow slowly and rarely spread.
• Mesenchymal: This type usually develops in your spine, ribs or jaw. These tumors often grow quickly. They’re more likely to spread than other chondrosarcomas and come back after treatment. Extraskeletal myxoid chondrosarcoma is a form of mesenchymal chondrosarcoma.

Symptoms of chondrosarcoma

Most chondrosarcomas grow slowly, causing symptoms that take months to develop. The most common symptoms are:

• Bone pain that comes and goes and gets worse at night
• Fatigue
• Swollen spot or lump on a bone, like on your arm, leg or ribs
• Unintentional weight loss

These symptoms don’t always mean bone cancer. But if you have a lump that doesn’t go away within two weeks or you feel exhausted all the time, talk to a healthcare provider. They’ll find out what’s causing your symptoms.

Chondrosarcoma causes

Researchers don’t know the exact cause. But they link the condition to genetic disorders, including:

• Li Fraumeni syndrome: People with this condition are likely to develop cancerous tumors, including chondrosarcomas.
• Maffucci syndrome and Ollier’s disease: These disorders cause benign tumors in your cartilage, bone and skin.
• Hereditary multiple osteochondromas: These are multiple benign bone tumors that can disrupt your bone growth.

Medical experts think that in some cases, a change in a chromosome or gene that’s unrelated to an inherited disorder may change cartilage cells.

Risk factors

You can develop a chondrosarcoma at any age, but the condition is more common in people ages 40 to 75. Most people receive a diagnosis at age 51.

Rarer forms, like mesenchymal chondrosarcoma, often affect adults ages 19 to 30.

How doctors diagnose chondrosarcomas

A healthcare provider will ask about your symptoms and do a physical exam. They may order:

• Imaging tests: Tests may include a bone scan, CT scan, MRI, PET scan or X-ray.
• Biopsy: An orthopaedist may remove tissue from a suspicious lump or the entire lump. A pathologist will examine the tissue for signs of cancerous cells.

If cells are cancerous, the pathologist will identify the tumor type and establish a tumor grade.

Chondrosarcoma grades

A tumor grade is a measure of how fast a tumor may grow and spread. Chondrosarcoma grades range from 1 (I) to 3 (III):

• Low-grade (grade I): Also called atypical cartilaginous tumors, these tend to grow the slowest and are very unlikely to spread.
• Intermediate-grade (grade II): These are slightly more likely to spread.
• High-grade (grade III): These are the most likely to spread.

How is chondrosarcoma treated?

The most common treatment is surgery to remove cancerous cartilage and bone. The specific surgery depends on factors like the kind of chondrosarcoma, its location and its grade. Surgeries for chondrosarcoma include:

• Curettage: Your provider scrapes the tumor tissue from your bone. Then, they replace the missing bone with bone graft material.
• Limb-sparing surgery: Your provider removes the tumor and nearby bone and muscle. You’ll get reconstructive surgery to replace the missing bone and tissue.
• Amputation: Your orthopaedist may recommend surgery to remove part of your arm or leg. They may suggest you have a prosthetic limb. But amputation is rare.

In all cases, you’ll have physical therapy to help you build strength, balance and mobility as you adapt to your situation.

If you have dedifferentiated or mesenchymal chondrosarcoma, you may have chemotherapy or radiation therapy before surgery to shrink the tumor. You may also need these treatments after surgery to kill any remaining cancer cells.

Recovery time

Living with chondrosarcoma usually starts with recovery. Treatment often involves removing part of a limb or the limb that contains the tumor. Once you’ve recovered, you’ll start a rehabilitation program to help you adjust to using a prosthetic limb.

You might need help adjusting to other changes in how you go about your everyday life. Or you may need help getting used to changes in your appearance. Your healthcare provider will suggest physical, occupational or mental health therapies that may help you manage these challenges.

When should I see my healthcare provider?

Ask your provider to explain the kinds of changes in your body that may be signs that cancer has come back, and when it makes sense for you to contact them.

Is there a cure for chondrosarcoma?

There are several types of chondrosarcomas, each with different prognoses or expected outcomes. In some cases, surgery to remove very small, slow-growing conventional chondrosarcoma tumors may cure the condition. Based on the type of chondrosarcoma, adding chemotherapy may help cure it.

But fast-growing chondrosarcomas like mesenchymal chondrosarcoma or dedifferentiated chondrosarcoma can be life-threatening.

Ask your healthcare provider what you can expect given your specific situation. They’ll explain your prognosis.

What are chondrosarcoma survival rates?

Survival rates for chondrosarcoma vary depending on the tumor type and whether the tumor is spreading. Data collected between 2012 and 2018 show that 78% of people with chondrosarcoma were alive five years after diagnosis. Here are specific survival rates based on tumor location:

As you think about your situation, try to keep a few things in mind about survival rates:

• A survival rate is an estimate based on the experiences of other people. Your situation may be different.
• These estimates reflect what happened in the past. They can’t predict the future.
• Survival rates don’t indicate how long you’ll live.

If you have questions about what a survival rate means in your case, ask your provider to explain how it factors into your situation.

What is the difference between chondrosarcoma and osteosarcoma?

Osteosarcoma starts in the bone and typically affects children. Chondrosarcoma starts in your cartilage and typically affects adults. Healthcare providers may treat chondrosarcoma with surgery alone and treat osteosarcoma with chemotherapy and surgery.